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Awareness

I’m very passionate about mental health and abuse awareness, mainly due to my own expieriances. I am very open about my past, which I know is something that many do not like, but I do not see why I should stay silent – afterall that’s what the abusers told me to do and I can’t let them win can I?

I don’t want nor do I expect pity or sympathy. I do not deserve it, and I do not want it, what happened happened and I am only who I am today because of it. I do not want hugs and people saying they are sorry, what I want, what I fight for every day, is for OTHERS to feel safe that they will not be judged. What I want is to make it so that those who currently suffer in silence scared of what may happen if they open up know that they are not alone, and maybe make it so that they no longer have to fear judgement and blame.

I know that my work and my speaking out will not end abuse, discrimination and suffering, but if I can just let people know that they are not alone and do not have to suffer in silence and maybe if I can make a few people stop and think then I am happy with that. I cannot stop abuse, I cannot change the world, but maybe I can help to plant the seeds of change, plant that idea in to the minds of others, and then they can help that idea to grow until one day change can and does occur. Maybe one day the things which I fight will no longer exist, but I doubt that I will see that day. I can do so little, but it’s the best I can do, I just have to hope that human nature is not as bad as I fear and that these seeds if change and the glimmer of hope will take root.

I tell my story, my truth, not for pity, but for the hope that I can help to ignite change in this world. I know most will not believe this, but I know my truth and I hope that a few of you know this truth too. This is why I spend so long creating websites, writting letters, speaking in schools, raising money and trying to spread awareness. It’s an inconvenient truth I know, but it’s a truth that needs to be known, I cannot just sweep it under the carpet when I know that it could help others. So I fight and strive with the hope of helping, of making the suffering of others that little bit better that bit more bearable. I wish that this truth was not there, that it did not need to be spread, but it is and it does. And for this I am sorry

Women who reported an incident of sexual victimisation during the last year are the most likely to say they felt very unsafe walking alone in their area after dark. Women who had been victimised within the last five years were more likely to feel unsafe than women victimised more than five years ago. Women who had ever been sexually victimised were also more likely to say they felt unsafe walking alone in their area after dark than women who did not report an incident of sexual victimisation

These figures should not be taken at face value. It is likely that different victims will react and feel differently when placed in specific situations with different real or perceived threats. In particular, lack of numbers prevented the separation of women who were the victims of attacks by different perpetrators. For example, it may be that women who were attacked outdoors by a stranger would be more likely to fear walking
alone than women not attacked in a public place. However, it could also be argued that any traumatic sexual victimisation will affect a victim’s feelings of vulnerability, trust or self-confidence and that this is the key factor when considering broad-brush attitude questions such as these.

The main British Crime Survey also contains a question asking whether women are worried about being raped. Again, it must be remembered that this attitude question is asked very early on in the main part of the BCS questionnaire, not in the specific context of the self-completion module;
and refers to women’s general worry about being the victim of rape, not survivors’ specific worries about being re-victimised. Lack of numbers also meant that responses had to be compared for victims of any sexual attack, not just rape victims. Bearing these limitations in mind, levels of worry among non-victims and those who had ever been a victim of a sexual attack were very similar. However, there is again more of a difference between non-victims and those recently victimised.

It must be remembered that some women in the ‘non-victims’ category may actually be victims who chose not to disclose this to the survey. These findings also lend weight to the argument that responses to ‘worry’ questions are determined more by experiences and consequences than by perceived risk

The 2000 self-completion module asked victims whether they experienced certain emotions after their most recent incident of sexual victimisation. Victims of attacks by partners or expartners appear, in some ways, to be slightly more emotionally affected by their experiences than women attacked by either strangers or acquaintances. Over four-fifths of women attacked by partners or ex-partners felt very angry and very upset by the incident, compared to about three-quarters of women victimised by acquaintances or strangers. However, victims of partner or ex-partner attacks were less likely to be very shocked by their victimisation than were victims of stranger attacks (64% Vs 76%).

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As anyone who has read The Morning After: Fear, Sex and Feminism by Katie Roiphe will know there is a general belief that talking about sexual violence, abuse, and other crimes can lead to a fear of violence and therefore is fear mongering. Roiphe argues that that by exaggerating the dangers faced by women, feminists have taken away the sexual freedom that were fought for so hard by so many. By implying that women are victims, they have made women feel weak and afraid. Fear of violence is, therefore, far greater than its actual incidence.
This may have some degree of reality within it. However, unfortunately this naivety can lead to the dismissal of the real threat by creating black/white thinking of either “the world is dangerous and scary, everyone is evil” or “the world is safe, everyone is nice and kind, and anyone who says it isn’t is lying”, this fails to realise that in reality the world is neither black nor white in fact it is generally grey. Naivety can also put people at risk, studies have shown that women who are aware of the potential hazards are not over trusting and are less likely to be assaulted. Not all people are violent, not all rape and not all are dangerous, but it is difficult (if not impossible) to tell those who are/do from others. I mean people don’t walk around with giant florescent lights above their heads naming their intensions.

I admit there may be a contradicting here, of wanting people to be free and independent but at the same time wanting people to be careful which may seem to infringe upon this independence. However, surely the resolution of this conflict involves speaking out about violence and campaigning for change to what society seems to regard as an acceptable level of violence. Until such a changes occur, however, we have no choice but to prepare our friends, children and others for what the world is, and regrettably this includes warning them of the dangers. A balance must be struck between empowering people to be independent, taking precautions’, in so far as possible, and campaigning for a change in the status quo. As much as I wish we could, we cannot alter the world to protect people from the truth, and I feel it would be irresponsible to go around telling people that everything is safe and to never be on their guard as it’s not needed… being on your guard and taking precautions’ is part of life, I mean you’d never cross the road without checking for cars would you? But first you need to know that roads and cars can be dangerous, same with people, people can be dangerous, people are vulnerable to harm, but there are things we can do to limit this vulnerability.

But how can we limit our vulnerability unless we know we are vulnerable to start with?

The sad thing is, sexual aggression in men is normalised and even praised in our society, to the detriment of all genders. Rape is not a joke. Rape is, in every case, a violation of law, international and domestic. It is not acceptable to have sex with a woman without her consent. It is not acceptable to joke about it or create the appearance that rape is funny, amusing, or acceptable. Making light of this horrific crime is a slap in the face to survivors of rape and women everywhere.

80 percent of all rapes are never reported to the police. Males report rape at even lower rates than females. The incontrovertible fact is that victims already feel hesitant to come forward, to speak, to tell their story, without feeling as if the world considers it a joke.

For those of you who wonder why rape victims get all super sensitive about rape jokes, well, this is why. Before you’re raped, rape jokes might be uncomfortable, or they might be funny, or they might be any given thing. But after you’re raped, they are a trigger. They make you remember what was done to you. And if the joke was about something that wasn’t done to you, not in quite that way, you can really easily imagine how it would feel, because you know how something exactly like that felt. Rape jokes stop being about a thing that happens out there, somewhere, to people who don’t really exist, and if they do they probably deserved it, and they start being about you. Rape jokes are about you. Jokes about women liking it or deserving it are about how much you liked it and deserved it. And they are also jokes about how, in all likelihood, it’s going to happen to you again.

Apart from that joking about things reinforces misconceptions and beliefs, people start to actually think that rape victims deserved it… NO ONE DESERVES TO BE RAPED!!! They start to believe that rape isn’t real, that people enjoy it but feel ashamed of the action the next day and so “cry rape”… and so slowly we develop a culture where rape becomes almost normal, and even acceptable… but rape is a crime, it’s not a joke, not a punch-line, not normal and DEFANTLY not acceptable. It also acts to belittle the experiance, making those who have been through rape feel that maybe it wasn’t a big deal, maybe they are overreacting, being pathetic…

The crux of the argument is this: rape jokes are triggering to rape survivors and reinforce rape myths, and seeing as so many women have survived rape, it might be considerate not to be joking about rape when you have no idea if someone listening has been affected by it

One of the diagnostic criteria for PTSD is hypervigilance. Hypervigilance is watchfulness or checking one’s surroundings that is over and above what is normal or reasonable. Hypervigilance takes many forms. It is what makes some of us always choose an aisle seat or one where our back is to a wall. It’s what makes some of us carry defensive weapons such as guns, knives, mace or pepper spray, a police whistle or a mobile phone set to 999. It makes some of us cross the street to avoid suspicious people. Some of us have alarm systems, multiple locks, window locks, high fences, guard dogs, etc. Another form of hypervigilance is studying people very carefully in an attempt to look deeply into their soul to determine exactly what they are made of. Hypervigilance is included in the cluster of symptoms referred to as “increased arousal”. This cluster also includes difficulty sleeping, irritability or outbursts of anger, difficulty concentrating, and exaggerated startle response.

This increased arousal stems directly from our trauma and the form it takes is shaped directly by the nature of our trauma. If we have difficulty sleeping, it may be because we were afraid to go to sleep or stay asleep for fear of an attack of some sort while we were not conscious to repel it or avoid it. If we are irritable, it may be to warn people to keep their distance or to not behave in ways that might trigger us. If we can’t concentrate it may be because we are too busy trying to monitor all inputs from possible dangers. If we startle easily it may be because we learned to jump quickly to get out of harm’s way. And if we are hypervigilant it is probably because we saw our environment as having multiple and unpredictable dangers that we should be on constant alert for. In fact, much of the time our hypervigilance helps to keep us safe.

However, the “hyper” in hypervigilance suggests that we do more than is normal or reasonable. It is too much because it is an inconvenience or an encumbrance. While it is probably true that we with PTSD are indeed safer because of all the precautions that we take, it is probably also true that our hypervigilance does often get in the way. It may be that we deprive ourselves of going certain places and of partaking in certain events. For example, we don’t go to an event because we can’t get an aisle seat, or because we don’t know what kind of people are going to be there. Sometimes we see people looking at us and we think that they are judging us or are hostile toward us. Sometimes we are afraid to eat certain foods because we are afraid of being poisoned or made ill. And, there are probably numerous other examples of ways in which hypervigilance inconveniences us.

Nightmares refer to complex dreams that cause high levels of anxiety or terror. In general, the content of nightmares revolves around imminent harm being caused to the individual (e.g., being chased, threatened, injured, etc.). When nightmares occur as a part of PTSD, they tend to involve the original threatening or horrifying set of circumstances that was involved during the traumatic event. For example, a rape survivor might experience disturbing dreams about the rape itself or some aspect of the experience that was particularly frightening.

Nightmares can occur multiple times in a given night, or one might experience them very rarely. Individuals may experience the same dream repeatedly, or they may experience different dreams with a similar theme. When individuals awaken from nightmares, they can typically remember them in detail. Upon awakening from a nightmare, individuals typically report feelings of alertness, fear, and anxiety. Nightmares occur almost exclusively during rapid eye movement (REM) sleep. Although REM sleep occurs on and off throughout the night, REM sleep periods become longer and dreaming tends to become more intense in the second half of the night. As a result, nightmares are more likely to occur during this time.

How common are nightmares?

The prevalence of nightmares varies by age group and by gender. Nightmares are reportedly first experienced between the ages of 3 and 6 years. From 10% to 50% of children between the ages of 3 and 5 have nightmares that are severe enough to cause their parents concern. This does not mean that children with nightmares necessarily have a psychological disorder. In fact, children who develop nightmares in the absence of traumatic events typically grow out of them as they get older. Approximately 50% of adults report having at least an occasional nightmare. Estimates suggest that between 6.9% and 8.1% of the adult population suffer from chronic nightmares.

Women report having nightmares more often than men do. Women report two to four nightmares for every one nightmare reported by men. It is unclear at this point whether men and women actually experience different rates of nightmares, or whether women are simply more likely to report them.

How are nightmares related to PTSD?

A person does not have to experience nightmares in order to have PTSD. However, nightmares are one of the most common of the ‘re-experiencing’ symptoms of PTSD, seen in approximately 60% of individuals with PTSD. A recent study of nightmares in female sexual assault survivors found that a higher frequency of nightmares was related to increased severity of PTSD symptoms. Little is known about the typical frequency or duration of nightmares in individuals with PTSD.

Are there any effective treatments for nightmares?

Yes. There are both psychological treatments (involving changing thoughts and behaviors) and psychopharmacological treatments (involving medicine) that have been found to be effective in reducing nightmares.

Psychological Treatment

In recent years, Barry Krakow and his colleagues at the University of New Mexico have conducted numerous studies regarding a promising psychological treatment for nightmares. This research group found positive results in applying this treatment to individuals suffering from nightmares in the context of PTSD. Krakow and colleagues found that crime victims and sexual assault survivors with PTSD who received this treatment showed fewer nightmares and better sleep quality after three group-treatment sessions. Another group of researchers applied the treatment to Vietnam combat veterans and found similarly promising results in a small pilot study.

The treatment studied at the University of New Mexico is called ‘Imagery Rehearsal Therapy’ and is classified as a cognitive-behavioral treatment. It does not involve the use of medications. In brief, the treatment involves helping the clients change the endings of their nightmares, while they are awake, so that the ending is no longer upsetting. The client is then instructed to rehearse the new, nonthreatening images associated with the changed dream. Imagery Rehearsal Therapy also typically involves other components designed to help clients with problems associated with nightmares, such as insomnia. For example, clients are taught basic strategies that may help them to improve the quality of their sleep, such as refraining from caffeine during the afternoon, having a consistent evening wind-down ritual, or refraining from watching TV in bed.

Psychologists who use cognitive-behavioral techniques may be familiar with Imagery Rehearsal Therapy, or may have access to research literature describing it.

Psychopharmacological Treatment

Researchers have also conducted studies of medications for the treatment of nightmares. However, it should be noted that the research findings in support of these treatments are more tentative than findings from studies of Imagery Rehearsal Therapy. Part of the reason for this is simply that fewer studies have been conducted with medications at this point in time. Also, the studies that have been conducted with medications have generally been small and have not included a comparison control group (that did not receive medication). This makes it difficult to know for sure whether the medication is responsible for reducing nightmares, or whether the patient’s belief or confidence that the medication will work was responsible for the positive changes (a.k.a., a placebo effect).

Some medications that have been studied for treatment of PTSD-related nightmares and may be effective in reducing nightmares include Topiramate, Prazosin, Nefazodone, Trazodone, and Gabapentin. Because medications typically have side effects, many patients choose to try a behavioral treatment first.

What happens if nightmares are left untreated?

Nightmares can be a chronic mental health problem for some individuals, but it is not yet clear why they plague some people and not others. One thing that is clear is that nightmares are common in the early phases after a traumatic experience. However, research suggests that most people who have PTSD symptoms (including nightmares) just after a trauma will recover without treatment. This typically occurs by about the third month after a trauma. However, if PTSD symptoms (including nightmares) have not decreased substantially by about the third month, these symptoms can become chronic. If you have been suffering from nightmares for more than 3 months, you are encouraged to contact a mental health professional and discuss with him or her the behavioral treatments described above.

The first thing to do is understand what happens to you and why. Ask professionals and do your own research from reliable sources about the symptom.

Understand something about what happens to your body when the symptom is triggered. For example, if you experience panic attacks, why do they happen? – what is the physical process which makes you feel so awful? – how can the physical reactions be controlled?

When you have information about why the symptom happens, then you have something to work with2: Understand yourself.

When you have information about why a symptom happens, compare this to how you feel and how the symptom is triggered in your life. How does it start? – how does your body react? – what are you thinking? You may be surprised at the similarities.

3: Think of a plan.

When you know why something happens and the real effect it has on you, you are in a position to develop a coping plan.

Emphasis is on ONE THING AT A TIME! Don’t try to rush it!

A common reaction to many symptoms is to try and ‘get away’ from them. Perfectly natural. But you can not do that if you want to control them and reduce their impact on your life.

For example, if a symptom occurs and the trigger is being in a public place, you need to develop an awareness of what the REAL situation is rather than what you THINK it is. So, imagine the scenario in an objective way. Is there a REA L threat to you? Are people REALLY interested in you? Are people REALLY bothered if you are there or not? You HAVE as much right as anyone else to be there!

Another example may be flashbacks. Perhaps your reaction is to get away from them – forget them. But you know what they are so you can do something about them. They are pictures in your mind – they are NOT the REAL situation you are in. So instead of trying to shy away from them, what would happen if you looked at them from an objective viewpoint? Really looked at them? Rationalised why they are happening? Perhaps understanding that a picture is only a picture and can not harm you.

Whatever plan you develop for a symptom is flexible. You can change it to suit you at any time. The important thing is to have a plan in the first place.

On thing of note is that you may not be able to make the symptom go away forever. It may still be present in some form for a very long time. You will need to accept this, but your attitude to it is the key. If the symptom happens, try not to get stressed – just let it pass then carry on.

4: Using the plan.

It is important that you realise that things take time and persistence. There is no ‘magic. With a plan you are informed and ready.

The first few times you use your plan you may find it extremely difficult, and it may be disturbing. STOP! DO NOT force yourself.

Try it again, and again – small steps. Also, you may have ups and downs. One time your plan may work and a few tries later it becomes very disturbing or difficult. That is OK. Just keep trying it.

If your plan doesn’t work at all, reassess the information you have and think of another plan – KEEP IT SIMPLE!

Conclusion

Not everything works for everybody all the time. The important thing is to think about the things that you need to do and how to overcome symptoms that stop you doing them.

We could go in-depth, but the important thing is you understand the general principle.